HIV infection is a global health emergency. Funding has recently become available to begin scale-up of HIV treatment in resource poor countries. Few data exist however, on barriers to HIV care in the developing world or how best to identify and engage HIV-infected patients in care in these settings - issues which are critical to successful implementation of treatment programs. Louise Ivers, MD is a 3rd year Infectious Disease fellow at Brigham and Women's and Massachusetts General Hospitals in Boston. She has had extensive clinical training in tropical medicine and infectious diseases, and is currently a research fellow in the Division of Social Medicine and Health Inequalities, working on an HIV treatment scale-up project in rural Haiti. This revised K23 proposal, entitled 'Identifying HIV and Related Stigma in Rural Haiti' has three specific aims: (1) To determine predictors of late presentation for HIV testing and care in rural Haiti.(2) To measure HIV-related stigma and to determine barriers to uptake of HIV testing and care in rural Haiti.(3) To evaluate the effectiveness of a routine HIV testing program in rural Haiti. Drs. Kenneth Freedberg and Paul Farmer will serve as mentor and co-mentor for this proposal. Both are senior faculty members at Harvard Medical School (HMS), with extensive HIV-related clinical research experience. HMS, by virtue of its rich multidisciplinary research environment and 20-year collaboration with the proposed research site in Haiti, provides an excellent environment for the candidate's professional development. Dr. Ivers' long-term career goal is to become an independent clinical investigator with emphasis on the evaluation of complex health interventions, such as HIV treatment, in resource poor settings. During the award period, she will develop advanced skills in epidemiologic and quantitative methods through didactic coursework leading to a Masters in Public Health degree at Harvard School of Public Health, and will greatly benefit from the combined expertise of renowned mentors and a deep institutional commitment to her success. [unreadable] [unreadable]